‘All for one’: City of Hope oncologist focuses on patients after evacuating fires
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Ravi Salgia, MD, PhD, and his family were watching coverage of the Los Angeles County fires on their television around 6 p.m. Jan. 7 when his wife looked in the backyard and saw a “huge red glow.”
She went outside, looked up and saw the house above them burning.
“She said, ‘We have to get out,’” Salgia, medical oncologist, professor and Arthur & Rosalie Kaplan chair of the medical oncology and therapeutics research department at City of Hope National Medical Center, a comprehensive cancer center near Los Angeles, told Healio. “We only had 5 minutes. We didn’t have any warning. At 6:30, we just took our valuables [and drove]. We had 5 minutes to leave the house.”
Salgia and his family have not returned to their home since. They have no idea what kind of damage has been done or if it is still intact.
That has not been his focus, however.
Since leaving home, Salgia has dedicated himself to caring for his patients and anyone else in need.
“My father would’ve said it the best: ‘You have to be strong in times of crisis,’” Salgia said. “You have to be available for everyone. I’m positive it’s going to hit me. I’m running on adrenaline, no question about it. All of us are, but we have to be there for our patients and our staff and our health care providers.
“If you really think about it, our patients [with cancer] are suffering a lot more than we are,” he added. “How do we support them?”
The fires have affected some City of Hope patients. Some have lost their homes and their livelihoods. Others — like Salgia — have been evacuated and have no answers.
“Everyone has a story,” Salgia said. “We’re seeing all different scenarios. It’s really a matter of individualizing each one and making sure we support each one of our patients.”
Salgia, a lung cancer specialist, is emphasizing that his patients take precautions amid the smoke by wearing masks, hydrating and maintaining their nutrition.
He’s also trying to care for his colleagues at City of Hope.
“We have to take care of each other, even as physicians. We’re not alone,” Salgia said. “What I admire the most is that nurses, physicians, administrators, everyone helps each other just be of sound mind and body. This is a crisis moment, just like when we had to face the COVID-19 crisis. We had to take care of patients but, at the end of the day, take care of ourselves.”
Salgia expressed his gratitude to everyone who helped him persevere over the past few days.
Around 2:30 a.m. on Jan. 8 — just hours after Salgia and his family evacuated and sought shelter in a hotel — he prepared to head to the City of Hope campus with just the clothes on his back.
He told his wife and daughter to go to Orange County to be safe.
“They said, ‘Absolutely not.’ They followed in their cars, and they actually came to the campus at City of Hope,” Salgia said. “They wanted to make sure not only that all the patients and everybody else was safe, but that I was also safe. That’s love. I’m very thankful for family.”
When he arrived, the nurses were “so kind” to him, Salgia said.
“They got me water, they got me tea and they got me toiletries,” he said.
During his interview with Healio, he recalled what he thought about as he made the 20-mnute drive from his hotel to City of Hope, not knowing what the future would hold.
“One for all, all for one,” Salgia told himself.
“This is what we teach our kids and the next generation,” he added. “We’re here to help others.”
‘Absolutely heartbreaking’
Salgia is only one of several City of Hope staff members directly affected by the wildfires.
At least 19 employees have lost their homes so far, according to Marcel van den Brink, MD, PhD, president of City of Hope Los Angeles and City of Hope National Medical Center.
Some staff members only had enough time to retrieve passports or other necessary items from their homes as they burned.
One physician is wearing surgical scrubs — not only because of his devotion to his job but because, for the moment, he has nothing else to wear.
“I have a whole cell phone full of photos that people sent me, and the text messages are absolutely heartbreaking,” van den Brink told Healio. “We have stories of people who literally had only 5 minutes to quickly grab something and get out.”
As the devastation spreads across the region, the number of these kinds of stories van den Brink hears continues to increase. However, he also has witnessed tremendous selflessness and compassion of committed professionals who continue to put others first despite horrific personal circumstances.
“The amazing thing for a number of our faculty members is that, despite the fact that they had lost their homes and had to figure out what to do with their lives, they came into the hospital anyway and did their tasks,” he said. “Two of our department chairs not only came in, but they did so during off-hours. We had people losing their homes, and then coming into the hospital in the middle of the night to do tasks they could have delegated to someone else.”
City of Hope set up a command center on Jan. 7. At that point, City of Hope had endured only power outages and winds.
After the Eaton wildfire broke out at 6:30 p.m. that day and worsened throughout the evening, authorities warned hospital officials there was a strong chance the blaze could reach the City of Hope campus.
“We had special meetings throughout the evening and, at around midnight, we decided that we needed to be ready for potential evacuation,” he said. “This was one of those moments when I was just so proud, so humbled and so amazed.”
The institution only had to make a few phone calls to its clinical leaders — nurses, staff and administrators — and within an hour or so, a group of about 60 people were rallying together to make detailed plans for each patient.
“This would have been an enormous task for a general hospital but, for patients at a cancer center like ours, the care is more complex,” he said. “We did this in the middle of the night because we knew it would take us about 6 or 7 hours to get all of the patients safely transported elsewhere and the staff and faculty off campus. The pace at which the fire was moving indicated we really needed to be ready.”
On Jan. 8, City of Hope’s main campus in Duarte was largely closed, with an additional half-dozen outpatient clinics throughout Southern California closed due to fire danger, evaluation orders or power issues.
Although the organization canceled nonessential appointments, City of Hope made sure that patients who needed immediate treatment were cared for.
“We can honestly say that the biggest impact on any treatment was that in some cases, we delayed care by a day or so,” van den Brink said. “That was only done in cases where we knew it was safe to delay care. In the overall balance, patient care was not negatively impacted.”
‘Compassion at the highest level’
The hospital continued to monitor the status of the fires throughout the day Jan. 8. Eventually the wind settled down and the fire began to move into the mountains.
By Jan. 9, City of Hope deemed it safe to reopen most of the closed clinics on a limited basis, with the Duarte campus accepting patients and trying to continue normal business operations.
Although the hospital plans to increase some of its capacity for care — including radiation oncology and surgery — this weekend, the hospital’s leadership understands the situation could change at any moment, van den Brink said.
“Our command center is still open,” van den Brink said. “We’re going to be very cautious about what we may still be facing. This is not over yet.”
As the hospital begins to return to normal, many staff members face the reality of having to begin rebuilding their lives. As that process begins, they will have the support of their City of Hope colleagues, van den Brink said.
The institution already has authorized rooms at an on-campus hotel, usually reserved for patients, to be used to provide shelter for displaced staff.
“I am absolutely amazed — I am a relative newcomer, having only been here for a year, but it really is a special culture here,” he said. “It’s a culture of compassion at the highest level — not just compassion for patients, which you need at any good hospital. It’s also compassion toward colleagues.”
Having worked at a cancer center in New York during the COVID-19 pandemic, van den Brink is no stranger to crisis response.
“I’ve learned my lesson — I’ve seen how these kinds of crises can play out,” he said. “What I’ve seen here is absolutely exceptional.”
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